动脉热灌注化疗治疗中晚期肝癌的疗效评价

Evaluation of Intra-arterial Thermochemotherapy in the Treatment of Advanced Hepatic Carcinoma

目的 观察经肝动脉热灌注化疗对中晚期肝癌的疗效和肝功能改变。材料与方法 选取 1996年 1月～ 1999年 1月中晚期肝癌患者 90例 ,随机分为 2组 ,A组 45例为热 (60℃ )灌注化疗组 ,B组 45例为对照化疗组 ,均采用经股动脉途径 ,插管至肝动脉用ADM +MMC + 5 FU +CDDP方案 ,间隔 40天再次治疗。治疗前后检测血清ALT、AST水平 ,并随访患者生存期。结果 A组 0 .5、1、1.5年生存率 (10 0 %、80 %、60 % )较B组 (84.4%、64 .4%、3 5 .5 % )均有提高 (P <0 .0 5 )。 2组治疗后血清ALT、AST水平增高无明显差异 (P >0 .0 5 )。A组恶心、呕吐等副反应较轻。

Objective To study the effectiveness of intra-arterial thermochemotherapy in the treatment of advanced hepatic carcinoma and to observe the influence of this therapy on hepatic function.Materials and Methods Ninety patients with advanced hepatic carcinoma, encountered during Jan. 1996～Jan. 1999, were randomly divided into group A (study group, n=45) and group B (control group, n=45). Intra-hepatic-arterial perfusion with ADM+MMC+5FU+CDDP in 9% sodium chloride solution was performed in all patients. For patients in study group the solution was warmed up to 60℃, while for patients in control group the temperature of solution was 37℃. The procedure was repeated after 40 days. Observation on serum ALT, AST levels before and after the therapy was made. The survival time of the patients was calculated.Results The 0.5, 1 and 1.5-year survival rate in group A was 100%, 80% and 60% respectively, which was higher than that in group B (84.4%, 64.4% and 35.5% respectively) (P<0.05). No significant difference was found in serum ALT, AST levels between two groups (P>0.05). Conclusion Intra-arterial thermochemotherapy is an effective and safe treatment to prolong the survival time of the patients with advanced hepatic carcinoma.